How to Lower Your Risk of Breast Cancer Today

Sara Daly Roter, 30

What I'm Doing: the most radical option—surgery

"Because I'm a carrier for one of the BRCA breast cancer genes and have a strong family history, I knew I had a very high probability of getting the disease. After investigating a lot of options, I came to believe that, sooner or later, breast cancer was going to disrupt my life. I had a prophylactic bilateral mastectomy—meaning both breasts were removed—followed by reconstruction. The peace of mind is worth it."

Ali Hochreiter, 29

What I'm Doing: Getting early screenings

"I had a breast MRI and a mammogram last year. Most women don't get mammograms until 40, but my mom was diagnosed with breast cancer at only 37 and died at 50. That makes me high-risk, so I started with screenings about 10 years before the age my mom was diagnosed."

Lorraine Gibson, 27

What I'm Doing: Walking three to four days a week

"My sisters and I watched our mom lose her battle with breast cancer when she was 45. I was in high school— and the memory still hurts. I sought support through the organization Bright Pink (bebrightpink.org), and started feeling ready to be proactive—now I exercise regularly to help reduce my risk."

Colleen Keefe, 29

What I'm Doing: Checking my breasts regularly

"My mother passed away from breast cancer in 1992. That made me very afraid for my own health, and I recently got tested for the BRCA genes. My results were negative, but I know that my family history still puts me at a higher risk than the average woman. I'm no longer afraid, but I do pay close attention to my breasts to keep an eye out for changes."

We all want a cure for breast cancer—that's a given. But wouldn't it be even more exciting if we knew how to never get the disease in the first place? New findings about the importance of "breast environment" are inching us closer to that goal, says Debbie Saslow, Ph.D., director of the breast and gynecologic cancer division at the American Cancer Society. Experts have found that whether a cancer-prone breast cell turns malignant can depend on the cells around it—and the overall health of your body. "Think of the breast cell as if it were a child," says Susan Love, M.D., founder of the Dr. Susan Love Research Foundation. "Where she lives can have a huge impact on whether she grows up to rob a bank, or run it." This breakthrough concept—of understanding what makes the environment around your breast cells (and other cells) toxic or healthy—is called epigenetics. It's complicated, but it's good news: Unlike hereditary BRCA breast cancer gene mutations, epigenetic changes can be reversed. "Through epigenetics, we're going to know a heck of a lot more about how to prevent breast cancer; it's exciting," says expert Randy Jirtle, Ph.D. Here's what experts know now, and what you can do to lower your risk.

1. Exercise—it could cut your risk by 23 percent

For years studies have hinted at the breast-health benefits of being active, but the idea that exercise lowers your risk of breast cancer is now hard to dispute. And based on current research, it appears to be the number-one thing you can do to lower your odds of the disease. One study funded by the National Cancer Institute found last year that women who averaged, over their lifetime, a little more than three hours a week of vigorous activity had a 23 percent lower risk of developing breast cancer before menopause than women who weren't as active. Other studies have found that more moderate activity has a protective effect too. What's so magical about exercise? "First, it lowers estrogen levels," says Dallas oncologist Yvonne Coyle, M.D., and estrogen is a well-known driver of cancerous changes in the breast. Working out also helps you maintain a healthy weight—and doctors know that decreases your risk too. But there may be other reasons exercise helps: Dr. Coyle's research suggests that it shields breast cells from both genetic and epigenetic changes. "Whatever the mechanism, being active is a sure way to lower risk, and it's available to everybody," she says. The American Cancer Society now advises women to get at least 30 minutes of exercise five days a week.

2. Watch what you drink

The research is clearer than ever: "Alcohol is a double-edged sword; it's been linked to a lower risk of heart disease but an increased risk of breast cancer," says Harvard preventive medicine specialist JoAnn E. Manson, M.D. One study found that each daily glass raises a woman's risk by up to 12 percent. Experts suggest sipping no more than a drink a day—perhaps less if you're at a higher risk of breast cancer because of family history or other risk factors.

3. Know your own breasts

Something of an earthquake shook the breast cancer world a few years ago, when a large, long-term study found that teaching women how to do a monthly breast self-exam (BSE) did not lower the risk of dying from breast cancer—instead, routine BSE led to unnecessary anxiety and follow-up tests like biopsies. Doctors and public health experts defended the practice to Glamour at the time: How could a monthly lump search not save lives? Still, similar reports kept coming, and the validity of the original study was upheld again and again. Now most experts agree that while every woman should get to know her own breasts, feel comfortable touching them and bring any changes to a doctor's attention, she doesn't have to go on a formal cancer hunt every month. "Most women do find their own cancer lumps, just not by doing self-exams," explains Dr. Love. "It's usually accidental, like when they roll over in bed or a lover finds it. Doing the formal song and dance is no better than the poking around we all do, and it could lead to unneeded tests."

4. Make smart reproductive health choices

"Too much estrogen probably plays a greater role in the development of breast cancer than anything else," says Dr. Coyle. Three well-documented risk factors—starting your period before age 12, reaching menopause after 55 and having your first child after 30—all steep breast cells in estrogen for a longer-than-average amount of time. Luckily, there are some ways to lower your risk with reproductive health choices that cut down on estrogen exposure. Breast-feeding, for example, lowers breast cancer risk, even among women who give birth later in life. And pregnancy timing counts. "As a breast doctor, I say, if you have a choice, have your first baby in your twenties," says Dr. Love.

As for estrogen in the Pill, most doctors agree that hormonal contraceptives slightly increase breast cancer risk. But Pill users, especially those under 40, shouldn't panic: "The risk of breast cancer in your twenties or thirties is so low that even if it doubled, it would be slight," says Dr. Love. "I'm more worried about someone older taking the Pill, when her baseline risk is greater." New York City ob-gyn Adelaide Nardone, M.D., agrees: "I give the lowest dose of oral contraceptives in general, and steer older women toward the nonhormonal IUD." Women with a family history of breast cancer should talk to their ob-gyns, but doctors Glamour interviewed say that for most young women, the Pill's benefits outweigh the small rise in breast cancer risk.

5. Get more vitamin D

No particular diet has been proven to lower breast cancer risk, but a growing number of studies point to a nutrient that seems especially beneficial: vitamin D. One such study found that women who got the most calcium and D had a 35 percent lower risk of breast cancer than those who got the least. Unfortunately, nearly 75 percent of us may have insufficient levels of the vitamin. You can get some from fortified dairy products and fish, but many experts now think taking 1,000 IU of the vitamin daily may be best for women.

Have two minutes? Help find a cure

One maddening problem facing cancer researchers: It often takes years—even decades—to recruit enough subjects for a thorough study. To help solve that, Susan Love, M.D., has partnered with the Avon Foundation for Women to create the Love/Avon Army of Women. The aim: to recruit a million study volunteers. (Reese Witherspoon is number 278,027.) Think of it like being in the Army Reserve: Sign up, and you may get a "call to action" e-mail. For some studies you may need to fill out a health diary; others may require checkups at a local hospital. The group is already speeding the progress toward a cure: "One study had been recruiting since 2002 and still needed 2,000 women," says Dr. Love. "We got them in two months!" Sign up at armyofwomen.org.

Could breast cancer disappear on its own?

There's an intriguing bit of research that has the breast cancer world buzzing: Results from a Norwegian study of 200,000 women suggest that in about 20 percent of cases, small cancerous changes and tumors in women's breasts may vanish—without treatment. How? There are several theories, but "it's possible that our immune system takes care of them," says Dr. Coyle. The finding could mean that some women go through unnecessary treatment for breast cancers that were never going to hurt them in the first place, says Lisa Schwartz, M.D., a professor of medicine at the Dartmouth Institute in Hanover, New Hampshire. But doctors may also eventually be able to identify early which types of tumors will fizzle and which will ignite—information that might spare women pointless trauma and eventually help scientists develop a cure.